Seorang Wanita 70 tahun dengan Keluhan Sulit Tidur, Gaduh Gelisah, dan Terlihat ada Bekas Ikatan pada

Kedua Tangan dan Kakinya

KELOMPOK 4

03006028 03006034 03007190 03007197 03008039 03008043 03008104 0300810+ 03008179 03008183 03008241 03008242 03008294

Anggia Prathama Arief Zamir Novi E i! Kh"mae!a N"r" #i$a%ah Arina Mana &i'ana Ar%( O'tarian )a%a *itri An"grah *itri!ia ,ahma Ni(ho a! ,e$ % N"ng'% -i$%a!t"ti .imothea &te/hanie .ri M"!ti'a0ati Norfarah 122ati 3. M$ A2man

FAKULTAS K !"KT #A$ U$I% #SITAS T#ISAKTI &AKA#TA, '' &anuari (0''

BAB I ) $!A*ULUA$ Per a'"an ta' 4enar terha$a/ an!ia 5e $er mi!treatment6 mer"/a'an !"at" 'on$i!i %ang o eh 4e4era/a to'oh geriatri $ima!"''an !e4agai !a ah !at" $ari !in$roma geriatri7 #a ini $i!e4a4'an !e ain 'arena 4e!aran in!i$enn%a teta/i 8"ga 'arena a'i4at %ang $i$erita o eh an!ia ter!e4"t ("'"/ mem/rihatin'an7 &eiring $engan mening'atn%a 8"m ah /o/" a!i an!ia9 'iran%a ti$a' $a/at $i/"ng'iri 4ah0a fre'"en!i 'e8a$ian /er a'"an ta' 4enar terha$a/ an!ia a'an mening'at $an 4ertam4ah 4e!ar /a$a 4e4era/a $e(a$e men$atang7 Per in$"ngan /a$a an!ia terha$a/ 'a!"! :mi!treatment; mer"/a'an 4agian /enting $ari /e a%anan geriatri( %ang 4er'"a ita!7 E $er mi!treatment men(a'"/ a$a $an ti$a'< a$an%a !ega a /er a'"an %ang men%e4a4'an tim4" n%a 'e8ahatan ata! 'e!ehatan $an 'e!e8ahteraan !eorang an!ia7 -a a"/"n !e(ara "m"m !ering $i' a!ifi'a!i'an !e4agai a4"!e fi!i'9 /!i'o ogi'9 ata" ver4a 9 /enga4aian $an finan!ia 9 !e4enarn%a $efini!i $ari /er a'"an ta' 4enar ini ma!ih 4er4e$a< 4e$a $ari !at" (enter 'e (enter ain7 Per a'"an ta' 4enar /a$a "!ia an8"t $i'ata'an mer"/a'an ha %ang "m"m7 =i4er4agai 4agian $"nia $i'ata'an in!i$en!in%a men(a/ai 2< + >9 $imana 'e8a$ian a4"!e e4ih 4an%a' $ari/a$a /enga4aian 5neglect67

BAB II LA)"#A$ KASUS 14" &iti 70 tah"n9 $i4a0a o eh 'e "argan%a 4ero4at 'e ' ini' tem/at !$r /ra'ti' $engan 'e "han "tama ti$a' 4i!a ti$"r $i ma am hari9 4i(aran%a 'a(a"9 ga$"h ge i!ah7 1nforma!i $ari 'e "argan%a men%ata'an 4ah0a !e8a' !"amin%a meningga !etah"n %ang a "7 14" &iti tingga 4er!ama ana' /erem/"ann%a %ang !"$ah 4er'e "arga $an mem/"n%ai tiga orang ana' ma!ing< ma!ing 4er"m"r 129 109 $an 8 tah"n7 Ana' %ang ter'e(i men$erita a"ti! %ang men%ita 4an%a' /erhatian $ari i4"n%a7 =i !am/ing it"9 ana' $an menant" 14" &iti a$a ah 'ar%a0an !e4"ah 3?MN %ang ("'"/ men%ita 4an%a' 0a't"7 O eh 'arena 'e!i4"'ann%a9 14" &iti !ering $itingga $i r"mah !en$irian $a am 'amar %ang ter'"n(i $an $emi 'eamanann%a9 'a'i $an tangan ter/a'!a !ering $ii'at "nt"' men(egah 'em"ng'inan ter8a$in%a 'e(e a'aan %ang ti$a' $iingin'an7 =ari anamne!i! $i'etah"i9 4ah0a !e8a' !"amin%a meningga !etah"n %ang a "9 'on$i!i 14" &iti tam/a' !e(ara $ra!ti( men"r"n ter"tama $a%a ingatn%a7 1a !ering "/a $imana 'amar ti$"rn%a $an !ia/a nama ana' $an ("("< ("("n%a7 &ifat /e "/an%a !ema'in he4at a'hir< a'hir ini9 4ah'an ia /ernah marah< marah minta ma'an /a$aha 4ar" !a8a ia $i4eri ma'an o eh ana'n%a7 Pa$a ma am hari 14" &iti !ering ge i!ah $an ti$a' 4i!a ti$"r9 o eh 'arena it"9 ana'n%a !ering mem4a0an%a 'e 4er4agai $o'ter %ang "m"mn%a mem4eri re!e/ o4at /enenang7 Pa$a /emeri'!aan $item"'an@ &eorang /erem/"an t"a9 70 tah"n9 tam/a' '"r"!9 emah9 'e!a$aran 4er'a4"t7 Kon8"ngtiva anemi!9 '" it tam/a' 'ering9 t"rgor '"rang7 =i $aerah /erge angan tangan $an 'a'i tam/a' "'a< "'a !e/erti 4e'a! i'atan $engan ta i7 =i $aerah /ingg" 4e a'ang $an /"ngg"ng ata! tam/a' "'a< "'a 4ernanah %ang 4er4a" ti$a' !e$a/7 &"h"@ 3698 AB7 #,@ 84CD menit7 .=@ 90D 60 mm#g7 Pernafa!an@ 24CD menit9 reg" ar9 norma 7 M" "t@ i$ah tam/a' 'otor9 gigi 4an%a' 'arie!9 4a" m" "t ti$a' !e$a/7 )ant"ng@ norma 7 Par"@ ron'i 4a!ah ha "! n%aring $i $aerah 4a!a 'e$"a /ar"7 A4$omen@ !"/e 9 4i!ing "!"! norma 7 #e/arD Lien@ ti$a' tera4a7 E'!tremita!@ ti$a' a$a e$ema7 ,ef e'! fi!io ogi!@ EDE7 ,ef e'! /ato ogi!@ <D<7 Pemeri'!aan %ang $i a'"'an !ete ah 'e!a$aran 14" &iti mem4ai'5 tam/a' 8ernih67 #a!i /emeri'!aan !tat"! menta 14" &iti@ &eorang 0anita 70 tah"n9 tam/a' !e!"ai $engan "!ian%a7 3er/a'aian !ea$an%a9 ram4"t ti$a' ter!i!ir ra/i9 e'!/re!i fa!ia tam/a' mengant"'7'e!a$aran ne"ro ogi!@ !omno en9 'e!a$aran /!i'o ogi!@ tergangg"7 3i(ara 'a(a" $an ti$a' 8e a!7 Moo$ tam/a' aga' hi/otim7 E'!/re!i afe'tif@ ti$a' !ta4i 9 /engen$a ian '"rang9 E(ht9 $a am9 a$e'"at7 =a/at $ira4ara!a'an9 !era!i9 $engan $iferen!ia!i men%em/it7 Per!e/!i@ i "!i $an ha "!ina!i ti$a' a$a9 $e/er!ona i!a!i $an $erea i!a!i ti$a' a$a7

Pro!e! /i'ir@ /ro$"'tifita! !e$i'it9 'ontin"ita! tergangg"7 * ight of i$ea! $an in'oheren!i ti$a' $item"'an7 1!i /i'ir@ /reo'"/a!i $an 0aham ti$a' a$a7 *"ng!i inte e't"a @ 'on!entra!i $an /erhatian tergangg"7 Orienta!i tergangg" 5tem/ora 9 /er!ona 9 !/a!ia 9 !it"a!iona 67 =a%a ingat 8ang'a /an8ang $an 8ang'a /en$e'@ !e$i'it tergangg"7 =a%a ingat !e!aat@ tergangg"7 =a%a ni ai !o(ia $an "8i $a%a ni ai !o(ia @ 4ai'7 .i i'an@ $era8at +7 #a!i /emeri'!aan /!i'ometri@ #=,&@ 309 MM&E@ 1+7 #a!i /emeri'!aan a4oratori"m@ #4@ 8 grD $ 9 e"'o!it@ +000D mmF9 LE=@ 80mmD 1 8am /ertama7 G" a $arah@ N@ 90 mgD $ 9 PP@ 140 mgD $ 7 Ko e!tero @ 2+0 mgD $ 9 .rig i!eri$a@ 1+0 mgD $ 7 &GO.@ 809 &GP.@ 707 ?re"m@ +0 mgD $ 9 Kreatinin@ 29+ mgD $ 7 ?rina i!i!@ G "'o!a@ negative9 Protein@ E19 Eritro!it@ 0<2D LP39 Le"'o!it@ 8< 10D LP37 EKG@ $a am 4ata! norma 7 BH,@ .am/a' 4er(a'< 4er(a' infi trate $i $aerah 4a!a $an /ara'ar$ia 'iri $an 'anan7 Ef"!i / e"ra@ ti$a' a$a7 .o'!i'o ogi@ 4en2o$ia2e/ine $a am $arah@ E7

BAB III ) +BA*ASA$

STATUS + $TAL A, !eskripsi u-u17 Penam/i an Pa$a /emeri'!aan /a!ien tam/a' '"r"!9 emah 'e!a$arn 4er'a4"t7 .am/a' !e!"ai $engan "!ian%a7 3er/a'aian !ea$an%a9 ram4"t ti$a' tam/a' !e!"ai $engan "!ian%a7 3er/a'aian !ea$an%a9 ram4"t ti$a' ter!i!ir ra/i9 e'!/re!i fa!ia tam/a' mengant"'7'e!a$aran ne"ro ogi!@ !omno en9 'e!a$aran /!i'o ogi!@ tergangg"7 3i(ara 'a(a" $an ti$a' 8e a!7

27 Ke!a$aran Ke!a$aran ne"ro ogi! Ke!a$aran /!i'o ogi! 37 Pem4i(araan Pa!ien 4i(ara 'a(a" $an ti$a' 8e a!7 @ &omno en @ .ergangg"

B, Ala- )erasaan 17 Afe' 27 E'!/re!i afe'tif &ta4i ita! Pengen$a ian E'!/re!i E(ht D "ne(ht =a am D $ang'a Em/ati &'a a $ifferen!ia!i Ke!era!ian @ .i$a' !ta4i @ K"rang @< @ E(ht @ =a am @ =a/at $ira4ara!a'an @ Men%em/it @ &era!i @<

., Fungsi intelektual /kogniti01 17 .araf Pen$i$i'an 27 =a%a 'on!entra!i 37 =a%a Orienta!i Per!ona =a%a Orienta!i .em/ora =a%a Orienta!i &/a!ia =a%a Orienta!i &it"a!iona 47 =a%a 1ngat )ang'a Pan8ang =a%a 1ngat )ang'a Pen$e' =a%a 1ngat &e!aat +7 Pi'iran A4!tra' 67 Kemam/"an Meno ong =iri !, Gangguan )ersepsi 17 #a "!ina!i 27 1 " ! i 37 =e/er!ona i!a!i 47 =erea i!a!i @ .i$a' a$a @ .i$a' a$a @ .i$a' a$a @ .i$a' a$a @< @ .ergangg" @ .ergangg" @ .ergangg" @ .ergangg" @ .ergangg" @< @< @ .ergangg" @< @<

, )roses pikir 17 3ent"' /i'ir 27 Ar"! fi'ir Pro$"'tifita! Kontin"ita! fi'iran #en$a%a 3er4aha!a 37 1 ! i * i ' i r Preo'"/a!i -aham K"antita! @ .i$a' a$a @ .i$a' a$a @< @ &e$i'it @ .ergangg" @< @<

*7 )engendalian i-puls G, !aya nilai 17 =a%a Ni ai &o!ia 27 ?8i =a%a Ni ai 37 =a%a /eni aian rea ita #7 Tilikan /Insight1 17 Tara0 !apat diper2aya

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@ 3ai' @ 3ai' @ 3ai' @ =era8at + @<

I%, STATUS FISIK A, Status u-uKea$aan ?m"m .am/a' '"r"!9 emah9 'e!a$aran 4er'a4"t7 .am/a' !e!"ai $engan "!ian%a7 .an$a Iita &"h" @ 3698AB7 #, .= ,, @ 84CD menit7 @ 90D 60 mm#g J #i/oten!i @ 24CD menit9 reg" ar9 norma J .a(h%/noe

Status Generalisata K" it Mata M" "t )ant"ng Par" A4$omen #e/arD Lien E'!tremita! @ tam/a' 'ering9 t"rgor '"rang7 @ 'on8"ngtiva anemi! @ i$ah tam/a' 'otor9 gigi 4an%a' 'arie!9 4a" m" "t ti$a' !e$a/7 @ norma 7 @ ron'i 4a!ah ha "! n%aring $i $aerah 4a!a 'e$"a /ar"7 @ !"/e 9 4i!ing "!"! norma 7 @ ti$a' tera4a7 @ ti$a' a$a e$ema7

B, Status $eurologis .an$a rang!ng meningea @ < ,ef e'2 fi!io ogi! ,ef e'2 /ato ogi! @ ED E @ <D <

., )e-eriksaan La3oratoriu!arah4 %aria3el #4 Le"'o!it LE= G=& G= PP Ko e!tero .rig i!eri$a &GO. &GP. ?re"m Kreatinin $ilai $or-al 12< 1+grD$ +000< 10000D mmF K 1+ mmD 8am K 140 mgD $ 100< 120 mgD $ K 200 mgD $ K 1+0 mgD $ +< 40 "D +< 41 "D 1+< 40 mgD $ 09+< 19+ mgD $ *asil La3 8 g> +000D mmF 80 mmD 8am 90 mgD $ 140 mgD $ 2+0 mgD $ 1+0 mgD $ 80 "D 70 "D +0 mgD $ 29+ mgD $ Interprestasi 5 N 6 N L L N 6 6 6 6

Urinalisis G "'o!a Protein Eritro!it Le"'o!it < < 0<1D LP3 0<3 D LP3 < E1 0<2D LP3 8< 10D LP3 N L N L

KG@ $a am 4ata! norma .7#@ 4er(a'< 4er(a' infi trate $i $aerah 4a!a $an /ara'ar$ia 'iri $an 'anan7

Toksikologi@ 4en2o$ia2e/ine $a am $arah@ E7 #a!i /emeri'!aan /!i'ometri@ #=,& 5 #a mi ton =e/re!i ,ating &(a e6@ +0 J ver% !evere 0<7 @N

8< 13 @ mi $ 14< 18 @ mo$erate 19< 23 @ !evere M23 @ ver% !evere

MM&E 5Mini Menta &tate ECamination6@ 1+ J mo$erate 'ognitive im/airment 26< 30 @ norma 21< 2+ @ mi $ (ognitive im/airment 10< 20 @ mo$erate (ognitive im/airment 0< 9 @ !evere (ognitive im/airment

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3A3 1I .1N)A?AN P?&.AKA 3A3 I =A*.A, P?&.AKA 3A3 I1 PEN?.?P